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General surgery training and robotics: Are residents improving their skills?

作者信息

Finnerty Brendan M, Afaneh Cheguevara, Aronova Anna, Fahey Thomas J, Zarnegar Rasa

机构信息

Department of Surgery, New York Presbyterian Hospital - Weill Cornell Medical College, 525 E. 68th Street, New York, NY, 10065, USA.

出版信息

Surg Endosc. 2016 Feb;30(2):567-573. doi: 10.1007/s00464-015-4240-8. Epub 2015 May 28.


DOI:10.1007/s00464-015-4240-8
PMID:26017910
Abstract

BACKGROUND: While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels. STUDY DESIGN: Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups. RESULTS: There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p < 0.001). The median overall scores did not differ: 188 (84-201) for MS, 183 (91-234) for JR, 197 (153-218) for MLR, and 205 (169-229) for SR (p = 0.14). The median SutureSponge score was highest for SR (61, range 39-81) compared to MS (43, range 26-61), JR (43, range 11-72), and MLR (55, range 36-68) (p = 0.039). However, there were no significant differences in MatchBoard (p = 0.27) or EnergyDissection (p = 0.99) scores between groups. There was a positive correlation between SutureSponge score and number of laparoscopic cases logged (p = 0.005, r(2) = 0.21), but this correlation did not exist for the MatchBoard or EnergyDissection tasks. Lastly, there was no correlation between total lifetime hours of video gaming and overall score (p = 0.89, R(2) = 0.0006). CONCLUSIONS: Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.

摘要

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本文引用的文献

[1]
General surgery residents' perception of robot-assisted procedures during surgical training.

J Surg Educ. 2015

[2]
Development of a virtual reality robotic surgical curriculum using the da Vinci Si surgical system.

Surg Endosc. 2015-8

[3]
Laparoscopic pancreaticoduodenectomy: a systematic literature review.

Surg Endosc. 2015-1

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Robotic surgery for colorectal cancer: systematic review of the literature.

Surg Laparosc Endosc Percutan Tech. 2014-12

[5]
Review of robotics in foregut and bariatric surgery.

Surg Endosc. 2015-1

[6]
Proficiency training on a virtual reality robotic surgical skills curriculum.

Surg Endosc. 2014-12

[7]
Trends in reported resident surgical experience in hysterectomy.

J Minim Invasive Gynecol. 2014

[8]
Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

Ann Surg. 2014-3

[9]
Validation of a virtual reality-based robotic surgical skills curriculum.

Surg Endosc. 2014-5

[10]
Training to maintain surgical skills during periods of robotic surgery inactivity.

Int J Med Robot. 2014-6

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